Complications of surgical closure of tracheo-cutaneous fistula in pediatric patients — two case reports

Tracheocutaneous fistula is seen frequently in decannulated children and respiratory complications associated with primary surgical closure can be potentially fatal. Cough is a precipitating factor for an air leak and we report two cases in which this occurred. A tracheotomy was performed on a 5-mon...

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Bibliographic Details
Published in:	International journal of pediatric otorhinolaryngology Vol. 52; no. 1; pp. 97 - 99
Main Authors:	Wiel, Eric, Fayoux, Pierre, Vilette, Bernard
Format:	Journal Article
Language:	English
Published:	Amsterdam Elsevier Ireland Ltd 30-01-2000 Elsevier
Subjects:	Biological and medical sciences Children Cutaneous Fistula - etiology Cutaneous Fistula - surgery Decannulation Female Follow-Up Studies Humans Infant Male Medical sciences Postoperative Complications Respiratory Tract Fistula - etiology Respiratory Tract Fistula - surgery Subcutaneous Emphysema - etiology Subcutaneous Emphysema - therapy Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the respiratory system Tracheal Diseases - etiology Tracheal Diseases - surgery Tracheo-cutaneous fistula Tracheotomy Tracheotomy - adverse effects Children Tracheotomy Decannulation Tracheo-cutaneous fistula Human Skin disease Diseases of the trachea Respiratory disease Male Fistula Suturation Case study Newborn Treatment Surgery Complication Female Skin Trachea
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Summary:	Tracheocutaneous fistula is seen frequently in decannulated children and respiratory complications associated with primary surgical closure can be potentially fatal. Cough is a precipitating factor for an air leak and we report two cases in which this occurred. A tracheotomy was performed on a 5-month-old girl for mechanical ventilation. Decannulation was successful at the first attempt. One year later, she presented with a persistent tracheo-cutaneous fistula. After surgical closure without drainage, she developed subcutaneous emphysema during a coughing episode. Sutures were removed. A 9-month-old boy presented with oxygen-dependence after lung disease and a tracheotomy was performed for respiratory support. Decannulation was successful at the first attempt 6 months later. He developed a pneumomediastinum after surgical closure of a tracheo-cutaneous fistula. Sutures were removed but replacement of a tracheotomy tube was required. In both cases the wounds were allowed to heal by secondary intention.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0165-5876 1872-8464
DOI:	10.1016/S0165-5876(99)00289-X